title: The importance of communication in the management of postoperative pain.
abstract: This study investigates the importance of communication in surgery and how delivering preoperative patient education can lead to better health outcomes postoperatively, via promoting tolerable pain scores and minimizing the use of narcotics after surgery. Patients who underwent outpatient surgery were randomly divided into groups to compare the pain scores of those who received preoperative patient education, the experimental group, and those who did not receive any form of patient education, the control group. Two weeks before surgery, the experimental group subjects received oral and written forms of patient education consisting of how the body responds to pain, and how endorphins cause natural analgesia. Moreover, patients were educated on the negative effects narcotics have on endorphin production and activity, as well as mechanisms of non-opioid analgesics. Of the 69 patients in the experimental group, 90% declined a prescription for hydrocodone after receiving preoperative education two weeks prior to surgery. The control group consisted of 66 patients who did not receive preoperative patient education and 100% filled their hydrocodone prescriptions. Patients in both groups were offered and received gabapentin and celecoxib preoperatively for prophylaxis of postoperative pain unless they declined. The control groups were found to have average pain scores significantly greater (P <.05) than the experimental groups and also a significantly longer (P <.005) duration of pain. This study illustrates the power of patient education via oral, written and visual communication, which can serve as an effective means to minimize narcotic analgesia after surgery.
authors.affiliation: Department of Internal Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA.
authors.forename: Daniel Y
authors.initials: DY
authors.lastname: Sugai
authors.forename: Peter L
authors.initials: PL
authors.lastname: Deptula
authors.forename: Alan A
authors.initials: AA
authors.lastname: Parsa
authors.forename: Fereydoun
authors.initials: F
authors.lastname: Don Parsa
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000588:Amines / Q000627:therapeutic use; D000700:Analgesics / Q000627:therapeutic use; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D000068579:Celecoxib; D003142:Communication; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use; D011307:Drug Prescriptions; D004723:Endorphins / Q000502:physiology; D000077206:Gabapentin; D006801:Humans; D006853:Hydrocodone / Q000627:therapeutic use; D008875:Middle Aged; D059408:Pain Management; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010353:Patient Education as Topic; D057240:Patient Preference; D011300:Preoperative Care; D011720:Pyrazoles / Q000627:therapeutic use; D013449:Sulfonamides / Q000627:therapeutic use; D055815:Young Adult; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use
chemical_list: D000588:Amines; D000700:Analgesics; D000701:Analgesics, Opioid; D003509:Cyclohexanecarboxylic Acids; D004723:Endorphins; D011720:Pyrazoles; D013449:Sulfonamides; D000082:Acetaminophen; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D006853:Hydrocodone; D000068579:Celecoxib
keywords: communication; education; endorphins; narcotics